Camptodactyly: classification and results of nonoperative treatment

To assess the relationship between clinical presentation and response to treatment, we reviewed the management of 59 involved proximal interphalangeal (PIP) joints in 22 patients with camptodactyly at a mean follow-up of 33 months. This population represented 24 cases of isolated infantile camptodactyly (type I), five cases of adolescent camptodactyly (type II), and 30 cases of syndromic camptodactyly (type III). Treatment response was assessed through passive range of motion measurements. Splinting and close adherence to an occupational therapy program were particularly effective for type I digits. We also recommend this approach for type II and type III camptodactyly, although severe deformities and well-established contractures are more common in these patients. We reserve operative intervention for only those patients who fail nonoperative management.